Healthcare Provider Details

I. General information

NPI: 1760457014
Provider Name (Legal Business Name): LAURA L SHELTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 SARATOGA BLVD STE 110
CORPUS CHRISTI TX
78414-4104
US

IV. Provider business mailing address

PO BOX 61160
CORPUS CHRISTI TX
78466-1160
US

V. Phone/Fax

Practice location:
  • Phone: 361-906-1277
  • Fax: 361-906-0330
Mailing address:
  • Phone: 361-884-2904
  • Fax: 361-371-8376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberK7612
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberK7612
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberK7612
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: